ATI RN
RN ATI Maternal Proctored Exam 2023-2024 with NGN Questions
Extract:
Question 1 of 5
A nurse is caring for a client who delivered by cesarean birth 6 hr ago. The nurse notes a steady trickle of vaginal bleeding that does not stop with fundal massage. Which of the following actions should the nurse take?
Correct Answer: D
Rationale: The correct answer is D: Administer 500 mL lactated Ringer’s IV bolus. In this scenario, the steady trickle of vaginal bleeding after a cesarean birth could indicate postpartum hemorrhage. Administering a lactated Ringer's IV bolus helps to stabilize the client's hemodynamic status by replacing lost fluids and improving perfusion. This is crucial in managing postpartum hemorrhage and preventing complications.
Incorrect choices:
A: Replacing the surgical dressing does not address the underlying issue of postpartum hemorrhage.
B: Evaluating urinary output is important but not the priority when dealing with postpartum hemorrhage.
C: Applying an ice pack to the incision site is not appropriate for managing postpartum hemorrhage.
Question 2 of 5
A nurse is assessing a newborn following a forceps-assisted birth. Which of the following clinical manifestations should the nurse identify as a complication of this birth method?
Correct Answer: D
Rationale: The correct answer is D: Facial palsy. Forceps-assisted birth can cause pressure on the baby's facial nerves, leading to facial palsy. This occurs due to the forceps' pressure on the baby's face during delivery. Polycythemia (
A) is a condition of increased red blood cell count, not typically associated with forceps-assisted birth. Hypoglycemia (
B) may occur in newborns but is not directly related to the birth method. Bronchopulmonary dysplasia (
C) is a chronic lung condition that develops in premature infants, not specifically linked to forceps delivery.
Question 3 of 5
A nurse is caring for a client who is at 37 weeks of gestation and is being tested for group B streptococcus ß-hemolytic (GBS). The client is multigravida and multipara with no history of GBS. She asks the nurse why the test was not conducted earlier in her pregnancy. Which of the following is an appropriate response by the nurse?
Correct Answer: D
Rationale: The correct answer is D because testing for GBS at 37 weeks of gestation allows healthcare providers to determine the current status of GBS colonization in the mother. This timing ensures that appropriate interventions, such as administering intrapartum antibiotic prophylaxis during labor, can be implemented to prevent neonatal GBS infection. Testing earlier in pregnancy may not accurately reflect the GBS status at the time of delivery.
Choices A, B, and C are incorrect because they do not address the specific rationale for testing at 37 weeks.
Choice A focuses on symptoms, which are not always present in GBS colonization.
Choice B refers to previous deliveries, which may not accurately predict the current GBS status.
Choice C mentions earlier prenatal testing, which may not capture GBS colonization at the time of delivery.
Question 4 of 5
A nurse is caring for a client who is 12 hr postpartum and has a fourth-degree laceration of the perineum. Which of the following actions should the nurse take?
Correct Answer: A
Rationale:
Correct Answer: A - Apply a moist, warm compress to the perineum.
Rationale: Applying a moist, warm compress helps to reduce swelling, promote healing, and provide comfort to the client with a fourth-degree laceration. The warmth improves blood circulation to the area, aiding in the healing process. It also helps to relieve pain and discomfort.
Summary of other choices:
B: Providing a cool sitz bath may be too cold and uncomfortable for the client with a fourth-degree laceration.
C: Administering methylergonovine is not indicated for a perineal laceration and may cause adverse effects such as hypertension.
D: Applying povidone-iodine to the perineum can be too harsh and may delay healing of the laceration. It is not recommended for this situation.
Question 5 of 5
A nurse is caring for a newborn who has jaundice and a new prescription for phototherapy. Which of the following actions should the nurse take?
Correct Answer: D
Rationale: The correct answer is D: Close the newborn's eyes before applying eyepatches. During phototherapy for jaundice, the baby's eyes should be protected from the light to prevent damage. Closing the newborn's eyes with eyepatches is crucial to shield them. Providing glucose water (
A), turning every 4 hours (
B), and applying hydrating lotion (
C) are not directly related to the phototherapy treatment. These actions could be unnecessary or even harmful. By selecting answer D, the nurse ensures the safety and well-being of the newborn during the phototherapy session.